Introduction and Background: HIV–AIDS has become a chronic manageable disease with the advent of antiretroviral therapy (ART). Kerala is the first state in India to start free antiretroviral treatment for HIV positive people in 2004. This study looked into the benefits of ART as experienced by, as well as the clinical and epidemiological profile of the patients attending ART clinics in Kerala. Methods: 124 patients attending in ART clinic, Thiruvananthapuram were enrolled. History and physical examination including body weight were recorded on a pre–designed schedule along with other clinical findings. The epidemiologic profile, probable route of infection and the perceived benefits of antiretroviral therapy were measured using a structured questionnaire. The CD4+ lymphocyte (CD4) count (cells/μl) was estimated at baseline and at 6–month interval during follow–up. Body weight and CD4 counts were compared with the baseline. Results: Three fourth of the subjects are in the economically productive age group (25–44 years) and males (63.7%) outnumbered the females (36.29%). The mean age was 35.2 years. Commonest mode of acquiring the infection was through heterosexual contact (67.7%). CD4 count has been increased following antiretroviral therapy in 92.5%. Mean increase is 175.73 (±133.5). 70.09% had weight gain and the mean weight gain was 4.15 kg. 78.2% patients had at least one opportunistic infection at the time of their first presentation in the clinic. The opportunistic infections have been significantly subsided in 58.06%. ART was very much useful for 46.77%, it improved their overall health and was just useful for 37.9%, benefits were not sure for 8.06% and 7.26% felt that ART gives no benefits at all. 22.9% of patients have some minor side effects. Conclusion: Antiretroviral therapy significantly improves the quality of life in HIV infected patients by reducing morbidity in terms of virus load and opportunistic infections. It also helps to regain their bodyweight.